Organization
MID MICHIGAN PEDIATRIC CARDIOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALLY A LECLAIR (OFFICE COORDINATOR)
(989) 752-8669
Entity
Organization
Contact information
Practice address
900 COOPER AVE, SUITE #4200, SAGINAW, MI 48602-5182
(989) 752-8669
(989) 752-4844
Mailing address
900 COOPER AVE, SUITE #4200, SAGINAW, MI 48602-5182
(989) 752-8669
(989) 752-4844
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301063051
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3507344422
BCBS OF MICHIGAN
MI
05
—
4180201
—
MI
Enumeration date
04/02/2008
Last updated
06/15/2009
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